A national analysis of the relationship between hospital factors and post-cardiac arrest mortality.
OBJECTIVE
We sought to generate national estimates for post-cardiac arrest mortality, to assess trends, and to identify hospital factors associated with survival.


METHODS
We used a national sample of US hospitals to identify patients resuscitated after cardiac arrest from 2000 to 2004 to describe the association between hospital factors (teaching status, location, size) and mortality, length of stay, and hospital charges. Analyses were performed using logistic regression.


RESULTS
A total of 109,739 patients were identified. In-hospital mortality was 70.6%. A 2% decrease in unadjusted mortality from 71.6% in 2000 to 69.6% in 2004 (OR 0.96, P < 0.001) was observed. Mortality was lower at teaching hospitals (OR 0.58, P = 0.001), urban hospitals (OR 0.63, P = 0.004), and large hospitals (OR 0.55, P < 0.001).


CONCLUSIONS
Mortality after in-hospital cardiac arrest decreased over 5 years. Mortality was lower at urban, teaching, and large hospitals. There are implications for dissemination of best practices or regionalization of post-cardiac arrest care.
Carr
Brendan G
BG
The Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. Brendan.Carr@uphs.upenn.edu
Goyal
Munish
M
Band
Roger A
RA
Gaieski
David F
DF
Abella
Benjamin S
BS
Merchant
Raina M
RM
Branas
Charles C
CC
Becker
Lance B
LB
Neumar
Robert W
RW
D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D002391:Catchment Area, Health; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000517:prevention & control*; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000592:standards* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology